Submental island flap as an alternative to microvascular free flap in intraoral defect reconstruction after ablative oral cancer surgery at resource constraint setting environment
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Reconstruction of intraoral defects following ablative oral cancer surgery remains challenging in resource-constrained settings where microvascular free flap reconstruction may not be readily available. This study aimed to evaluate the clinical outcomes of the submental island flap (SIF) as an alternative reconstructive option for intraoral defects following oral cancer resection. Methods A retrospective cross-sectional study was conducted in the Department of Otorhinolaryngology and Head & Neck Surgery at Purbanchal Cancer Hospital/B&C Medical College Teaching Hospital, Birtamode, Jhapa, Nepal. Medical records of patients who underwent SIF reconstruction following ablative oral cancer surgery between July 2021 and December 2025 were reviewed. Demographic, clinicopathological, surgical, adjuvant treatment, and outcome variables were analyzed using descriptive statistics. Results A total of 45 patients were included, with a mean age of 57.67 ± 11.39 years; 75.56% were male. Tobacco chewing was the most common risk factor (91.11%). The gingivobuccal sulcus was the predominant tumor site (42.22%), and squamous cell carcinoma accounted for 82.22% of cases. Wide local excision with marginal mandibulectomy was the most frequently performed procedure (60.00%). Early-stage disease (Stage I–II) was observed in 64.44% of patients. WPOI-5, lymphovascular invasion, and perineural invasion were present in 17.78%, 17.78%, and 20.00% of patients, respectively. Postoperative radiotherapy and chemotherapy were administered to 35.56% and 26.67% of patients, respectively. During follow-up, tumor recurrence occurred in six patients (13.33%). Successful flap survival was achieved in 43 patients (95.56%). Conclusions The submental island flap demonstrated a high success rate and acceptable oncological outcomes. It represents a reliable and effective alternative to microvascular free flap reconstruction for intraoral defects, particularly in resource-constrained settings.
Source: Research Square
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204162251